Cortisone

Written By Brett Scoles

Corticosteroid (cortisone) is a medication that can be injected into a joint, muscle, or tendon to reduce inflammation. It is commonly used for arthritis, tendinopathy (tendinitis), bursitis, and radiculopathy (nerve pain). It works by reducing the inflammation, which can reduce pain and stiffness. Cortisone is effective in short term pain relief in a variety of conditions. This quick fix does not come without side effects.

Local potential side effects include:

  • Flare up of pain: up to 35% of people depending on diagnosis

  • Infection: more of a risk if performed before surgery

  • Skin atrophy (thinning)

  • Calcification of soft tissue

  • Tendon rupture and ligament instability: cortisone can weaken tendons and ligaments and increase the risk of tears in the short and long term

  • Acceleration of arthritis

Systemic potential side effects include:

  • Facial flushing

  • Adrenal suppression: decreased body’s natural cortisol production

  • High blood sugar after injection: especially in diabetics

  • Osteoporosis: reduction in bone density even after 1 injection

Cortisone injections shouldn’t be the first line of treatment for musculoskeletal pain. There are alternative treatments that are more effective in the short and long term for pain and dysfunction.

Alternative Treatments

Dry needling is an alternative treatment that doesn’t involve injecting any medications. Dry needling uses small solid needles that are placed into a muscle. Dry needling has been shown to have similar effects on pain in the short term compared to cortisone. Dry needling has better effects in the long term and also less side effects. If you are going to get poked by a needle, choose dry needling. 

Physical therapy is also an effective alternative to cortisone injections. Physical therapists can use a variety of techniques to reduce pain. They are also able to work on range of motion, strength, balance, endurance, and functional activities, unlike an injection. Along with reducing pain, physical therapy can improve your overall quality of life and function. 

If you are in pain, choose a treatment that is going to improve your pain, health, and function with minimal side effects.


Brett Scoles
Next

Myths About Physical Therapy